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NPI Code Detail

MEDICARE: SHANNON ELIZABETH SHEPHERD CNM

MEDICARE: SHANNON ELIZABETH SHEPHERD CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice MidwifeAPRN9341130FL
2367A00000XAdvanced Practice MidwifeAPRN11010478FL
3367A00000XAdvanced Practice Midwife253199MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114904976
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON ELIZABETH SHEPHERD CNM
Provider Business Mailing Address
First Line : 216 14TH AVE SW
Second Line :
City : SIDNEY
State : MT
Zip : 59270-3519
Country : US
Telephone Number : 406-488-2100
Fax Number :
Provider Business Practice Location Address
First Line : 216 14TH AVE SW
Second Line :
City : SIDNEY
State : MT
Zip : 59270-3519
Country : US
Telephone Number : 401-488-2100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2005
Last Update Date : 12/31/2024

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Directions to “ SHANNON ELIZABETH SHEPHERD CNM” Practice Location

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